Insomnia is the inability to sleep despite having a normal opportunity to sleep during the normal sleep period. It is the most common sleep disorder. EVERYONE experiences insomnia occasionally - usually it is short lived. It can result from many causes and its severity and duration varies widely from individual to individual. About 1/3 of people have some difficulty sleeping for a period of time every year, and about 20% of people consider the problem serious. Insomnia is more common in women and more common as one gets older. The longer the duration of wakefulness before bedtime, the greater the likelihood of sleep. The best sleep generally takes place at night. Exposure to bright light in the early morning hours tends to reset the normal awake/sleep cycle so that bedtime sleep comes earlier.



Insomnia of less than 3 weeks is considered short term insomnia. Some of the many causes of this include acute stress, a death in the family, hospitalization, recovery from surgery, pain, the use of stimulant drugs, alcohol use, withdrawal from sedatives or sleeping pills and air travel.



Insomnia of longer than 3 weeks duration is considered long term insomnia. This disorder can be associated with the use of sedative or sleeping medications, alcohol use, drug abuse, depression, sleep apnea, narcolepsy, psychiatric disorders, post-traumatic stress, senility, thyroid problems, arthritis, Parkinson's disease and asthma, to name a few. To varying degrees all people with chronic insomnia have anxiety about falling asleep or the loss of sleep and this anxiety itself may perpetuate the problem. People who have extreme delayed sleep, that is, they stay up until 3 to 6 A.M. in the morning before they can fall to sleep, can be conditioned to go to sleep earlier by delaying bedtime by 2 to 3 hours each day until they reach normal bedtime hours again.



First, slowly withdraw from excessive or ineffective sedatives, sleeping pills, alcohol, caffeine or other drugs that may interfere with sleep. Find ways to reduce and manage your daily stress. If you can identify a specific cause of insomnia, notify your doctor of this. Go to bed, and get up in the morning at the same time every day, even on weekends. Avoid long periods of wakefulness in bed; get up if you can't sleep. Don't read, watch TV or work in bed. If you can't get to sleep within 30 minutes, get up and don't return to bed until you are drowsy. Don't nap during the daytime. Exercise regularly, at least 4 times a week, but not in the evening if this interferes with sleep.



Sleeping pills do not cure insomnia, but they sometimes can be helpful for short periods of time. They should be taken 30 to 60 minutes before bedtime. They should be used for less than 3 weeks. When stopped, they should be tapered down, taking a smaller dose each night for several nights rather than just stopping them "cold turkey." Sleeping pills not uncommonly will cause a slight daytime "hangover", and may impair daytime performance. The larger the dose of the sleeping pill, the more likely will be a "hangover." One over the counter drug, Benedryl, will work as a mild sleeping pill fairly effectively for short periods of time.  The dose used to cause drowsiness is usually 50 mg.


 Revised 8/08



ŠTed A. Tobey, M.D., Inc. ~ All Rights Reserved